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US home healthcare spending will climb about 7% annually from $103 billion in 2018 to $173 billion by 2026 — a trend that's symptomatic of fundamental shifts in how US hospitals and health systems earn revenue. The rise in home healthcare comes as inpatient admissions decline, hospital margins tighten, and patients gravitate toward more convenient locations for urgent and primary care, often at the expense of providers' revenue. These dynamics — combined with the rise of value-based healthcare payments, which tie hospital compensation to cost-effective patient outcomes — point to a need for hospitals to diversify their revenue streams and extend their reach into new care settings.

Geisinger — a Pennsylvania-based health system that encompasses 13 hospital campuses and a health insurance plan — created a home-based care model, dubbed Geisinger at Home (GaH), in April 2018 that reduced admissions by bringing telehealth-enabled care to high-risk, high-need patients. Business Insider Intelligence spoke with Geisinger at Home CMO Dr. Sanjay Doddamani, Geisinger Health Plan VP of Population Management Joann Sciandra, and Geisinger Associate VP of Telemedicine David Fletcher to get a better sense of Geisinger's strategy for providing home-based care and using digital tools to improve patient outcomes.

Challenge: Geisinger’s existing care model couldn’t adequately meet the complex needs of very ill patients, which contributed to high admission rates and medical costs. About 8-10% of Geisinger patients — who are predominantly older with a high burden of serious chronic disease — account for 50% of medical spending. “It’s frustrating seeing the same patients coming back to the emergency department, getting weaker and sicker because they have unmet needs,” Dr. Doaddamani said. Further, traveling to a doctor can be challenging when patients are acutely ill and conditions can flare up outside physician office hours — and delayed access to care can contribute to poor outcomes. 

Strategy: Geisinger's GaH program uses telehealth to facilitate comprehensive home-based care for its most expensive and admission-prone patients. The [...]